Stoma Care
Questions Received:
Responses:
I have had an ileostomy for over 15 years with very minor problems. Last week, after several days of a minor diarhea, I suffered a severe blockage at the stoma and was only able to relieve it by physically "picking it out", and straining with my abdominal muscles to force liquid to flush it. Now the diarhea has relented but the area around the stoma is extremly sore (internally) and burns when peristalsis occurs.
Any suggestions or help, please!
3rd September 1999
The symptoms that you describe in relation to your ileostomy may be related to your diet. The first line of approach should be to review your diet. Having had your ilesotomy for such a long period you will know the kinds of food that suit you best. Nevertheless, a review should be undertaken and a possible dietary link at least excluded. Foods such as nuts, raisins, celery and raw vegetables tend to produce constipation whilst spicy foods, fruit, vegetables, coffee and beer tend to produce diarrhoea.
Physically probing your stoma when you experience what you describe as "a severe blockage" is unwise as by doing so you risk traumatising the stoma and distal region of the small bowel. This could lead to severe complications. You are advised to contact your own doctor and if possible a Colorectal Nurse Specialist. These people will be able to reappraise your management and enable you to gain fresh insight into preventative measures that can be taken. If the reason for your ileostomy was as a treatment for previous inflammatory bowel disease then reporting your latest set of symptoms becomes essential.
We wish to thank Rosemary Baker, Colorectal Nurse Specialist at the Royal Devon & Exeter Healthcare NHS Trust, Exeter, Devon for her help and guidance with this question.
My mother recently has been diagnosed with inflammatory breast cancer and colon cancer. After having gone through radiation and chemotherapy, she had to have an emergency colostomy which left her with two colostomy bags. They did not remove the tumor because she could not go through a surgery that big. She has since had a mastectomy and is now going through radiation for her breast cancer. The cancer also involved her lymph nodes.
My question is after the colostomy, they said her stomas would get smaller,but instead after three months, they are getting larger. Why is this? Could it be that the tumor is getting bigger? She is afraid to ask her doctor, but I feel I need to know in order to help her. Why are her stomas getting bigger and is this a common thing?
30th June 2000
First of all it is not clear why your mother has two colostomy drainage bags. From what you describe it rather sounds as though your mother has a double barrel colostomy, probably performed as a palliative procedure to relieve large bowel obstruction. If this is the case then one part of the colostomy (the proximal stoma - stoma means mouth or opening) functions and the other (the distal stoma) is non-functioning. Normally however one stoma drainage bag is used to cover both areas.
The tendency is for the stoma/s to reduce in size gradually during the convalescent period. This may take several months to achieve but as the inflammation coupled with the oedema that arises from surgery gradually resolves so the stoma/s reduce in size.
It would be unwise to speculate about the failure of your mother's stomas to settle. It will be best if you consult your mother's own doctor or contact the local stoma care nurse. A call to your doctor or to the hospital where your mother underwent surgery should enable you to arrange a visit. Meanwhile it will be helpful if you can obtain information regarding your mother's eating and drinking patterns, and particularly the kind of foods she consumes, for example whether high or low residue.
If you remain concerned you should consider consulting the surgeon who carried out your mother's operation, if this is practical.